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Dynamics of RSV hospitalization rates in ≤ 2-year-old children between 2020-2023 in Europe

Joanne G Wildenbeest1, Louis Bont2, Daniela Cianci3

  • 1Department of Paediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands. j.g.wildenbeest@umcutrecht.nl.

European Journal of Pediatrics
|September 13, 2025
PubMed

Insights

Respiratory Syncytial Virus (RSV) hospitalization incidence in young children significantly varied between 2020-2023. Following a decline during COVID-19, RSV hospitalizations rebounded, highlighting the need for ongoing surveillance and adaptable prevention strategies.

Area of Science:

  • Pediatric infectious diseases
  • Epidemiology
  • Public health

Background:

  • Respiratory Syncytial Virus (RSV) is a leading cause of hospitalization in children globally.
  • RSV seasonality patterns were significantly altered by the COVID-19 pandemic.

Purpose of the Study:

  • To establish baseline RSV hospitalization incidence in young children prior to widespread implementation of new preventive strategies.
  • To assess the impact of the COVID-19 pandemic on RSV hospitalization rates across five European countries.

Main Methods:

  • Population-based incidence calculation using hospitalization data for children ≤ 2 years with confirmed RSV infection (2020-2023) in France, Germany, Spain, Italy, and the UK.
  • Comparison with pre-pandemic (2018-2019) hospitalization data.
  • Analysis of Pediatric Intensive Care Unit (PICU) admission trends.

Main Results:

  • RSV hospitalization incidence decreased during the 2020-2021 season (5.9/1000 child-years) compared to pre-pandemic levels (11.3/1000 child-years).
  • A significant rebound in incidence was observed in subsequent seasons, reaching 18.8/1000 child-years in 2022-2023.
  • Despite fewer overall admissions in 2020-2021, PICU admissions increased compared to the pre-pandemic period.

Conclusions:

  • RSV hospitalization incidence in children ≤ 2 years is substantial and exhibits significant year-to-year variability.
  • The observed decline and subsequent rebound underscore the dynamic nature of RSV epidemiology post-pandemic.
  • Continuous RSV surveillance and flexible preventive strategies are essential for managing disease burden.

Keywords:
COVID-19 pandemicChildrenPopulation-based incidenceRSVRSV hospitalization

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